The OMIG Releases its 2017-2018 Work Plan

The New York State Office of the Medicaid Inspector General (“OMIG”) has released its annual Work Plan for fiscal year 2017-18.  The annual Work Plan offers providers insight into OMIG’s areas of focus in the New York State Medicaid program for the upcoming year.  As stated in the Work Plan, the OMIG’s overall mission “is […]

ATTENTION OASAS PROVIDERS: JUSTICE CENTER INCIDENT REPORTING

Recently, the Counsel of OASAS, Robert Kent, sent a memorandum to all providers regarding Justice Center incident reporting policies and procedures for all OASAS providers. OASAS has also published a guidance document for incident reporting to the Justice Center under Part 836 of the OASAS regulations. Many OASAS providers have a process and procedure whereby […]

Governor Cuomo Announces Over $50 Million in Funding for Home Health Services for Senior Citizens Not Yet Eligible for Medicaid

Today, New York Governor Andrew Cuomo announced that $50 million in funding from the state’s Expanded In-Home Services for the Elderly Program has been awarded to the state’s county-based Area Agencies on Aging for the purpose of helping New York’s senior citizens to obtain home health care services.  The press release states that the funding “will […]

Comptroller Claims NYSDOH Leaves $95 Million of Drug Rebates on the Table

This week, the New York State Comptroller, Thomas P. DiNapoli, issued audit findings which claimed that the New York State Department of Health (“DOH”) failed to capture $95,100,000 in prescription drug rebates it was eligible to receive on drugs administered through the New York State fee-for-service program and the Medicaid Managed Care program from April […]

Behavioral Home and Community-Based Services Delayed

The New York State has delayed implementation of Behavioral Home and Community-Based Services (“HCBS”) outside of New York City.  These new services were scheduled to begin on July 1, 2016, but are now slated to be phased in three months later, on October 1, 2016. Non-HCBS behavioral health care services will be offered through Medicaid […]

New York State Comptroller Audits Social Adult Day Programs

New York State Comptroller Thomas DiNapoli today released an audit of Social Adult Day Services (“SADS”) programs in New York State.  The audit is available here.  Among other recommendations, the Comptroller asks the New York State Department of Health and New York State Office for the Aging to consider more closely regulating these programs.

Office of the State Comptroller Issues Medicaid Program Integrity Report

The New York State Medicaid program is projected to have a $62 billion-dollar price tag in State Fiscal Year 2016, with $22.4 billion paid out by the State, as explained by the New York State Office of the Comptroller (“OSC”) in its April 2015 report entitled Ensuring Integrity in New York State Medicaid.   As Medicaid […]

Office of The Medicaid Inspector General Releases 2015-2016 Work Plan

The New York State Office of the Medicaid Inspector General (“OMIG”) has released its State Fiscal Year 2015-2016 Work Plan.  The Work Plan is a road map of where the OMIG intends to go in terms of its anti fraud, waste and abuse efforts with respect to the Medicaid program. The OMIG’s stated mission is […]

Regulatory Focus on Mental Health Parity Laws

This month’s article from the Albany County Bar Association Newsletter discusses the New York Attorney General’s recent settlement with Excellus, a Rochester-based health insurer, which resulted from an investigation into complaints from consumers that Excellus was improperly denying claims for mental health and substance abuse treatment.  The article also includes a brief overview of New […]

New York State’s Medicaid Fraud Control Unit by the Numbers

Medicaid Fraud Control Units (“MFCUs”) have a responsibility to combat Medicaid fraud and patient abuse and neglect.  Toward that end, each MFCU maintains statistical data as to the number of investigations, indictments, and convictions by the MFCUs, as well as the amount of monetary recoveries for both civil and criminal cases.  Each year, a summary […]